Chinese metropolises face shortage of caregivers in nursing homes[Les métropoles chinoises face à la pénurie d’aides-soignantes dans les maisons de retraite]

China currently has 42 million elderly dependents whose long-term care needs can no longer be met by the family system that has prevailed until now. The government at all levels is encouraging the production of nursing homes (yanglaoyuan), but the shortage of caregivers is acute. This article analyzes the characteristics of the supply of nursing aides in the yanglaoyuan of two major provincial capitals with a population of 10 million (Hangzhou, a prosperous coastal city, Zhengzhou, a developing inland city), providing account on public and private initiatives to develop professional care facilities. The survey covered 31 yanglaoyuan in Hangzhou and 27 in Zhengzhou. It revealed a low level of qualification of the nursing staff due to the predominance of rural migrant women between 45 and 55 years of age, a lack of nursing skills and a low general level of remuneration. However, there has been a rise in nursing skills in Hangzhou, owing to two main drivers: financial support from the municipal government for the training and upgrading of nursing assistants' salaries on the one hand, and the contribution of foreign operators to the dissemination of nursing knowledge and techniques on the other. These characteristics are not matched by Zhengzhou, where yanglaoyuan production is still low, mainly due to the less advanced stage of economic development of this inland metropolis.